G72.2
BillableMyopathy due to other toxic agents
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is G72.2 an HCC code?
No. G72.2 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
G72.2 is the ICD-10-CM diagnosis code for myopathy due to other toxic agents. This code describes muscle weakness or disease caused by exposure to toxic substances such as drugs, chemicals, or other harmful agents. The muscle damage results from the toxic effects of these substances rather than from infection or genetic causes. G72.2 sits in the ICD-10-CM chapter for diseases of the nervous system (g00-g99), within the section covering diseases of myoneural junction and muscle (g70-g73).
G72.2 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Always identify and document the specific toxic agent causing the myopathy, as this information should be coded separately using an external cause code (Chapter 20, codes starting with T or X).
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for G72.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Always identify and document the specific toxic agent causing the myopathy, as this information should be coded separately using an external cause code (Chapter 20, codes starting with T or X)
- •Ensure the myopathy is confirmed to be toxic in origin rather than due to other causes like infection, inflammation, or metabolic disorders; review clinical documentation for evidence of toxic exposure and temporal relationship to symptom onset